Treatment

Elimination of the sensitizing antigen(s) may not be the only treatment necessary for dogs and cats with cutaneous adverse food reaction. During the early stages of the food trial, many dogs and cats require a short course of glucocorticoids to break the itch-scratch-itch cycle.

Also it is essential that secondary bacterial pyoderma, Malassezia dermatitis, or otitis externa/media be resolved during the initial portion of the food trial. The patient should be able to maintain the test diet alone, without any ancillary therapy, for 3 or 4 weeks before ending the trial. If the clinical signs (e.g., pruritus, otitis externa) have resolved during the trial, a challenge with the former diet should be performed (Box 6-2). Pruritus or otitis externa should recur within 14 days of exposure to the original diet. The diet is then changed back to the test diet, at which point all clinical signs should resolve. At that time, the dog or cat is placed on a commercially prepared restricted diet for 14 days. If clinical signs do not recur during this time, this diet is used as the base diet. Individual ingredients (beef, chicken, egg, pork, cottage cheese, dairy, wheat, soy, corn, fish) are fed for up to 14 days. If a recurrence of clinical signs occurs when the new ingredient is added, the ingredient is removed from the base diet and the patient is fed only the base diet until the clinical signs resolve. At that time, a new ingredient is added to the base diet. If after 14 days the patient’s clinical signs do not recur, this ingredient is placed on the “safe to feed” list (see Box 6-2). After all ingredients have been tested, the owner is able to feed whatever commercial diet is preferred as long as it avoids ingredients that cause a reaction in the dog or cat. However, it has been reported that up to 20% of dogs cannot be managed on any commercial food.^25,26

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Source: Gotthelf Louis N.. Small Animal Ear Diseases: An Illustrated Guide. 2nd ed. — Saunders,2004. — 384 p.. 2004

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